The Lymphatic System Flashcards
Lymphatic Development
Mesoderm produces?
Endoderm produces?
Mesoderm: Lymphatic vessels, lymph nodes, spleen & myeloid tissue
Endoderm: Thymus and parts of the tonsils
*Take home message: We have lymphatics early on (5th week)
Physiologic functions of Lymphatic system?
- Immue
- Digestive
- Fluid Balance
- Waste
Spleen
Location
Characteristics
Functions
Location: Under ribs 9-11 on left
Characteristics: Largest single mass of lymphoid tissue, pressure sensitive
Functions: Destroy damaged/deformed RBCs, synthesize Ig’s, Clear bacteria
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Anatomically, what drives splenic fluid movement?
Movement of the diaphragm
Liver
Location
Characteristics
Functions
Location: RUQ
Characteristics: Pressure sensitive
Functions: 1/2 of body’s lymph formed in liver, clears bacteria, “gate-keeper” of shared hepatobiliary-pancreatic venous and lymphatic drainage
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Thymus
Location
Characteristics
Functions
Location: Anterior mediastinum
Characteristics: Large during infancy, and size peaks at 2 y/o. After puberty, replaced by fatty tissue.
Functions: Maturation site for T cells, little/no function in adults.
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Tonsils
Location
Characteristics
Functions
Location: 3 types, all in posterior oropharynx
Characteristics: Most are visible until 6-9m/o, remain enlarged throughout childhood
Functions: Provide cells to influence and build immunity early in life, nonessential to adult immune function
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Appendix
Location
Characteristics
Functions
Location: Proximal end of the cecum
Characteristics: contains lymphoid pulp
Functions: part of the gut associated lymphoid tissue (GALT)
Visceral Lymphoid Tissue
What is GALT?
GALT =
Gastrointenstinal Associated Lymphoid Tissue
Includes:
Peyer’s patches, Lacteals
What tissues DO NOT have lymphatic vessels (however use direct diffusion)?
- Epidermis
- Endomysium (inner lining of muscle cells)
- Cartilage
- Bone marrow
What is the order of lymphatic drainage starting from lymphatic capillaries?
Lymphatic capillaries –>
Collecting lymphatics –>
Afferent lymphatic vessels –>
Efferent lymphatic vessels –>
Thoracic duct/R lymphatic duct –>
Venous system
How is extracellular fluid sucked into lymphatic vessels?
Low level negative pressure
The lymphatic collectors consist primarily of chains of muscular units called _____________, which contain _________
These are aka?
Lymphangions
two-leaflet bicuspid valves
“lymphatic hearts”
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Lymph nodes
Location
Characteristics
Functions
Location: ALL OVER
Characteristics: Superficial and deep types
Functions: filtration of lymph fluid, matruation of lymphocytes, phagocytosis of bacteria and cellular debris
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Describe the path of lymph flow through a lymph node
- Afferent lymphatics
- Subcapsular space
- Outer cortex
- Deep cortex
- Medullary sinus
- Efferent lymphatics
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What lymph node is this?
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Virchow’s node
What lymph node is associated here?
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Epitrochlear Nodes
*Associated with secondary syphilis
Mechanisms of Flow: Direct Diaphragmatic Pressure
What are the two diaphragms involved?
Thoracic Diaphragm
Pelvic Diaphragm (4 muscles)
What are the effects of sympathetic nervous system on lymph valves?
Increased sympathetic tone –>
Tigher valves –>
DECREASED LYMPH FLOW INTO THE VENOUS SYSTEM
What happens with a poorly functioning lymphatic system?
EDEMA
What are the effects of edema?
- Compression of local structures (decreased delivery of O2, nutrients, meds, hormones, decreased neuronal sensation)
- Decreased tissue waste removal
-Decreased pathogen clearance and immunity
What are the indications for lymphatic OMT?
- Edema, tissue congestion or lymphatic stasis
- Infection
- Inflammation
*Chronic conditions should be approached with caution. Gentler techniques, shorter, but more frequent treatment sessions preferred
What are absolute contraindications for lymphatic omt?
Anuria
Necrotizing fasciitis
Pt. unable to tolerate treatment
Pt. refuses treatment, lol
Principles of Diagnosis from a Lymphatics approach
Describe the general 5 steps
- Evaluate risk-benefit ratio
- Evaluate fascial patterns of ZINK
- Evaluate diaphragms/fascia
- Evaluate for somatic dysfunction
- Evaluate tissue congestion
What is the COMMON ZINK compensatory pattern?
L/R/L/R
80% of healthy people
What is the UNCOMMON ZINK compensatory pattern?
R/L/R/L
20% of healthy people
Un-compensated zink patterns usually arise from…
Trauma
*Usually symptomatic
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